Determining medical service improvement priority by integrating the refined Kano model, Quality function deployment and Fuzzy integrals

In recent years, owing to the rise in consumers' consciousness with regard to health care quality, hospitals are constructively probing into the factors affecting patients' satisfaction. This is to enable them identify technical items of medical services and to see it as a priority to utilize these items. Using quality function deployment (QFD) with the Refined Kano model, this study aims to prioritize above all the use of various medical service technical items as an improvement directed towards hospitals' competitiveness. With the outpatient services of a hospital as the empirical case study, this study first collected the service requirements of the patients and classified them using the Refined Kano model to decide the weights of each patient's service requirements, then found out the different medical service technical items which the hospital provided to satisfy the service requirements, and utilized the Fuzzy Integral approach to calculate the improvement index of each medical service technical item in order to determine the priority of improvement. With the Refined Kano model analysis it is found that there are three high value-added qualities, seven critical qualities, five necessary qualities, another five highly attractive qualities, four less attractive qualities, and two care-free qualities. Further analysis of the QFD proposed the primary medical service technical items as staff training, facility safety, hospital location, cordial service, equipment maintenance, and advanced medical equipment. This study presents a simple and feasible approach for hospitals to confirm the service demands of patients, to determine the improvement sequence corresponding with patients' demands under limited resources, focus on the most attractive demands and the priority items for improvement, in order to enhance competitiveness in an efficient and effective way.